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Do blood flow patterns in the left atriums differ between left upper lobectomy and other lobectomies? A computational
Wentao Yi1, Tomohiro Otani1, Shunsuke Endo2
1Department of Mechanical Science and Bioengineering, Graduate School of Engineering Science, Osaka University, Osaka, Japan.
Frontiers in Cardiovascular Medicine
|January 22, 2024
Summary
Left upper lobectomy (LUL) alters left atrial (LA) blood flow, increasing viscous dissipation near the pulmonary vein (PV) stump. Patient-specific hemodynamic assessments are crucial after lobectomies to understand these distinct flow patterns.
Area of Science:
- Cardiovascular Physiology
- Thoracic Surgery
- Medical Imaging
Background:
- Pulmonary vein (PV) resection during lung lobectomy can alter left atrial (LA) hemodynamics, increasing thrombosis risk.
- Left upper lobectomy (LUL) with left superior PV resection shows distinct LA flow patterns and disturbances near the PV stump.
- Previous imaging studies had limitations in resolving these complex flow dynamics.
Purpose of the Study:
- To compare LA blood flow patterns after LUL with those following other lobectomies.
- To investigate the impact of PV resection on LA hemodynamics using computational simulations.
Main Methods:
- Computational fluid dynamics simulations based on 4D CT scans from four lung cancer patients.
- Modeled five scenarios per patient: pre-resection and four PV resection types.
- Evaluated global LA flow patterns and PV inflow dynamics, particularly in the upper LA region.
Main Results:
- LUL cases showed enhanced left inferior PV inflow and impingement of right PV inflows near the PV stump.
- Viscous dissipation significantly increased in LUL cases, reaching 3-4 times higher than pre-resection levels in most patients.
- Flow dissipation varied, influenced by the relative strength of PV inflows and patient-specific anatomy.
Conclusions:
- Significant patient-to-patient variability exists in LA hemodynamics post-lobectomy.
- Patient-specific hemodynamic assessment is essential for understanding and managing risks associated with lobectomy-induced flow alterations.
